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Organizing your personal affairs

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Organizing your personal affairs

Organizing your personal affairs

Published in: Economy & Finance, Business

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  • 1. Organizing Your Personal Affairs ___________________________________ABOUT YOU________________________________ Your legal name___________________________________________________________________ Address__________________________________________________________________________ City__________________________________ State________________ Zip Code______________ Date of birth______________________ Place of birth_____________________________________ City__________________________________ State_________________ Zip Code_____________ Your citizenship________________________________ Your race__________________________ Your religious affiliation_____________________________________________________________ Occupation or former occupation (kind of work you did most of your life)_____________________ Your education: High School ______________________ College___________________________ Graduate School_______________________________ Other_______________________________ _______________________________SIGNIFICANT OTHER__________________________ Marital Status: ___Married ___Divorced ___Widowed ___Other___________ Name of spouse____________________________________________________________________ Spouse’s place of birth______________________________________________________________ _______________________________________FAMILY_________________________________ Mother’s maiden name_____________________________ Her place of birth__________________ Her address_______________________________________________________________________ City__________________________________ State_________________ Zip Code_____________ Father’s name____________________________________ His place of birth__________________ His address_______________________________________________________________________ City__________________________________ State_________________ Zip Code_____________
  • 2. _____________________________________CHILDREN________________________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ ___________________________________GRAND CHILDREN_________________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ ______________________________________SIBLINGS________________________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________ Name___________________________________________________ Phone___________________
  • 3. ____________________________________GOD PARENTS____________________________ Name__________________________________________________ Phone____________________ Name__________________________________________________ Phone____________________ ____________________OTHER PERTINENT FAMILY MEMBERS__________________ Name___________________________________ Relationship______________________________ Phone__________________________ Name___________________________________ Relationship______________________________ Phone__________________________ Name___________________________________ Relationship______________________________ Phone__________________________ Name___________________________________ Relationship______________________________ Phone__________________________ _____________________________________MILITARY________________________________ Dates of service______________________________ Branch of service_______________________ Rank____________________________ Service Number__________________________________ Wars/conflicts served: First___________________________ Second_________________________ Location of discharge papers (you will need a copy of these papers)__________________________ ___________________________FRATERNAL ORGANIZATIONS____________________ Name_________________________________ Address___________________________________ City__________________________________ State________________ Zip Code______________ Name_________________________________ Address___________________________________ City__________________________________ State________________ Zip Code______________
  • 4. ____________________________INSURANCE INFORMATION______________________ Health Insurance Company______________________________ Policy Number________________ My policy is located at:______________________________________________________________ Life Insurance Company________________________________ Policy Number________________ My policy is located at:______________________________________________________________ Beneficiary_______________________________ Contingent_______________________________ My policy is located at:______________________________________________________________ Long Term Care Company_______________________________ Policy Number_______________ My policy is located at:______________________________________________________________ Annuity Insurance Company_____________________________ Policy Number________________ My policy is located at:______________________________________________________________ Disability Insurance Company____________________________ Policy Number_______________ My policy is located at:______________________________________________________________ Other Policies: Company________________________________ Policy Number________________ Amount_________________________ Reason Purchased_________________________________ My policy is located at:______________________________________________________________ ________________________________PENSION DETAILS____________________________ Name of Company_______________________________________ Phone_____________________ Type (401k, RRSPs, RRIFs, etc.)______________________________________________________ Value_______________________________ Other_______________________________________ Name of Company_______________________________________ Phone_____________________ Type (401k, RRSPs, RRIFs, etc.)______________________________________________________ Value_______________________________ Other_______________________________________
  • 5. ________________________________CREDIT CARDS________________________________ Card Type_____________________________________________ Expiration Date_____________ Additional Card Holder____________________________________ Relationship_______________ Telephone Number of Additional Card Holder___________________________________________ Card Type_____________________________________________ Expiration Date_____________ Additional Card Holder____________________________________ Relationship_______________ Telephone Number of Additional Card Holder___________________________________________ Card Type_____________________________________________ Expiration Date_____________ Additional Card Holder____________________________________ Relationship_______________ Telephone Number of Additional Card Holder___________________________________________ Card Type_____________________________________________ Expiration Date_____________ Additional Card Holder____________________________________ Relationship_______________ Telephone Number of Additional Card Holder___________________________________________ Card Type_____________________________________________ Expiration Date_____________ Additional Card Holder____________________________________ Relationship_______________ Telephone Number of Additional Card Holder___________________________________________ Card Type_____________________________________________ Expiration Date_____________ Additional Card Holder____________________________________ Relationship_______________ Telephone Number of Additional Card Holder___________________________________________ ___________________________SAFETY DEPOSIT BOX_____________________________ I have a Safety Deposit Box? ___Yes ___No Box Number________________________ It is located at___________________________________ Contact Number____________________ Additional Key Holder____________________________ Contact Number____________________ In the event of no Additional Key Holder the contents of the box is to be opened by: _______________________________________________ Contact Number____________________
  • 6. ___________________________FINANCIAL INSTITUTIONS________________________ Savings Account Location (Name of Bank)______________________________________________ Name of Joint Account Holder_______________________________ Phone___________________ Savings Account Location (Name of Bank)______________________________________________ Name of Joint Account Holder_______________________________ Phone___________________ Checking Account Location (Name of Bank)____________________________________________ Name of Joint Account Holder_______________________________ Phone___________________ Checking Account Location (Name of Bank)____________________________________________ Name of Joint Account Holder_______________________________ Phone___________________ _______________________________POWER OF ATTORNEY_________________________ I have a will: ___Yes ___No It is located at name/place:_______________________________________ Phone:______________ City__________________________________ State________________ Zip Code______________ My attorney’s name is:__________________________________________ Phone:_____________ City__________________________________ State________________ Zip Code______________ The executor of my Will is:______________________________________ Phone:______________ City__________________________________ State________________ Zip Code______________ I have a living will: ___Yes ___No It is located at:_____________________________________________________________________ City__________________________________ State________________ Zip Code______________ I have a medical Power of Attorney: ___Yes ___No It is located at:_____________________________________________________________________ City__________________________________ State________________ Zip Code______________ The person designated under my Medical Power of Attorney is:______________________________ Address____________________________________________________ Phone:_______________ City__________________________________ State________________ Zip Code______________
  • 7. ______________________________FUNERAL ARRANGEMENTS____________________ I have already made my funeral arrangements: ___Yes ___No I wish to have my body: ____Buried (at___________________) ____Cremated (given to_______________________) ____Donated (to___________________________) I would like a: __Traditional Funeral __Direct Burial __Direct Cremation __Other(___________) I would like my ceremony to be: ___Religious ___Personalized ___Military ___Other________ I wish to have my funeral handled by:__________________________________________________ Phone_________________________ Address___________________________________________ City__________________________________ State________________ Zip Code______________ I want my Viewing/Funeral to be: ___Open Casket ____Closed Casket ____Other__________ I would like my service to be conducted by:_____________________________________________ Phone_________________________ I would like my eulogy to be conducted by:______________________________________________ Phone_________________________ I would like to request the following people as Pallbearers: Name_________________________________________________ Phone_____________________ Name_________________________________________________ Phone_____________________ Name_________________________________________________ Phone_____________________ Name_________________________________________________ Phone_____________________ Name_________________________________________________ Phone_____________________ Name_________________________________________________ Phone_____________________ I would like to be buried wearing______________________________________________________ I would prefer to be buried wearing my jewelry: ___Yes ___No I would like to have the following songs played at my funeral:_______________________________ _________________________________________________________________________________ In honor of my memory I would prefer: ____Flowers be sent to the Funeral Home ___ Donations to be made to:______________________ ___Other:_______________________ Special Instructions:________________________________________________________________
  • 8. ________________________ORGAN DONATION INFORMATION__________________ Are you an Organ Donor: ___Yes ___No If it is at all possible I would like to have the following organs donated: _____None ____All ___Heart ___Liver ___Kidney ___Lung ___Pancreas ___Intestine ___Cornea ___Skin ___Bone ___Bone Marrow ___Eyes ____Other:__________________ Donor_______________________________________________________ Date_______________ Witness______________________________________________________ Date______________ Witness______________________________________________________ Date______________ ____________________________COPIES OF THIS DOCUMENT_____________________ Copies of this document have been probated: ___Yes ___No Copies of this document are kept by the following people: Name______________________________________________ Phone________________________ Address____________________________ City____________________ State_______ Zip_______ Name______________________________________________ Phone________________________ Address____________________________ City____________________ State_______ Zip_______ Name______________________________________________ Phone________________________ Address____________________________ City____________________ State_______ Zip_______ Name______________________________________________ Phone________________________ Address____________________________ City____________________ State_______ Zip_______ Name______________________________________________ Phone________________________ Address____________________________ City____________________ State_______ Zip_______
  • 9. HOW I WOULD LIKE MY HEADSTONE, FOOTSTONE, & OBITUARY TO READ The following should be followed: ___Exactly ___As a guideline ___At discretion ___Does not matter Headstone: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Footstone: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Obituary: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________
  • 10. _________SPECIFIC CONTACTS AT THE TIME OF PASSING VIA PHONE_______ Call:(name)______________________________________ At (phone)_______________________ Tell them:________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Tell them to contact__________________________________At (phone)______________________ Call:(name)______________________________________ At (phone)_______________________ Tell them:________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Tell them to contact__________________________________At (phone)______________________ Call:(name)______________________________________ At (phone)_______________________ Tell them:________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Tell them to contact__________________________________At (phone)______________________ Call:(name)______________________________________ At (phone)_______________________ Tell them:________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Tell them to contact__________________________________At (phone)______________________ Call:(name)______________________________________ At (phone)_______________________ Tell them:________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Tell them to contact__________________________________At (phone)______________________
  • 11. _________SPECIFIC CONTACTS AT THE TIME OF PASSING VIA MAIL_______ Name___________________________________ Address_________________________________ City________________________________ State_______________________ Zip_____________ I already have a letter written for them: ___Yes ___No If Yes it is located__________________________________________________________________ If No, Please write__________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Name___________________________________ Address_________________________________ City________________________________ State_______________________ Zip_____________ I already have a letter written for them: ___Yes ___No If Yes it is located__________________________________________________________________ If No, Please write__________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Name___________________________________ Address_________________________________ City________________________________ State_______________________ Zip_____________ I already have a letter written for them: ___Yes ___No If Yes it is located__________________________________________________________________ If No, Please write__________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________
  • 12. ______________________________CONFIDENTIAL_________________________________ THE FOLLOWING INFORMATION IS CONSIDERED PERSONAL & CONFIDENTIAL, THEREFORE IT IS TO ONLY BE VIEWED BY THE INTENDED RECIPIENT This letter is intended solely for_______________________________________________________ of (address)_________________________ (city)_________________ (state)_______ (zip)_______ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________
  • 13. PUBLIC LETTER TO ALL IN ATTENDANCE AT MY FUNERAL FROM, ME _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ I would like for the fore mentioned letter to be read aloud at my service by____________________, or, if they are unavailable ________________________________. Thank you in advance for complying with my wishes. Sincerely,
  • 14. ___________________________MY PERSONNAL INFORMATION__________________ Favorite Bible Verse________________________________________________________________ Favorite Song_____________________________________________________________________ Favorite Holiday___________________________________________________________________ Favorite Place_____________________________________________________________________ Favorite Color_____________________________________________________________________ Most Important Event in My Life______________________________________________________ Saddest Day of My Life_____________________________________________________________ Favorite Saying____________________________________________________________________ Lucky Number(s)__________________________________________________________________ Hobbies__________________________________________________________________________ _________________________________________________________________________________ Most Prized Possession______________________________________________________________ Best Friend(s)_____________________________________________________________________ Accomplishments__________________________________________________________________ Favorite Charity___________________________________________________________________ Greatest Goal_____________________________________________________________________ Favorite Movie____________________________________________________________________ Favorite TV Show__________________________________________________________________ Favorite Actor/ Actress______________________________________________________________ Favorite Car______________________________________________________________________ Other Things of Personal Interest______________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________
  • 15. __________________________AUTOMOBILE/ VEHICLE DETAILS__________________ Vehicle Model_________________________________________ Year_______________________ Vehicle Identification Number_____________________________________ Tag_______________ Ownership Status: ___Own ___Leased ___Financed to Own Leasing/ Finance Company_____________________________________ Phone________________ Date of End of Lease/ Finance Period___________________ Monthly Payment________________ Co-owners Name____________________________________________ Phone_________________ Insurance Name__________________________________ Policy Number____________________ Notes____________________________________________________________________________ Vehicle Model_________________________________________ Year_______________________ Vehicle Identification Number_____________________________________ Tag_______________ Ownership Status: ___Own ___Leased ___Financed to Own Leasing/ Finance Company_____________________________________ Phone________________ Date of End of Lease/ Finance Period___________________ Monthly Payment________________ Co-owners Name____________________________________________ Phone_________________ Insurance Name__________________________________ Policy Number____________________ Notes____________________________________________________________________________ Vehicle Model_________________________________________ Year_______________________ Vehicle Identification Number_____________________________________ Tag_______________ Ownership Status: ___Own ___Leased ___Financed to Own Leasing/ Finance Company_____________________________________ Phone________________ Date of End of Lease/ Finance Period___________________ Monthly Payment________________ Co-owners Name____________________________________________ Phone_________________ Insurance Name__________________________________ Policy Number____________________ Notes____________________________________________________________________________
  • 16. ___________________IMPORTANT DOCUMENTS LOCATIONS___________________ Lock Box and/or Other Important Keys_________________________________________________ Birth Certificate(s)_________________________________________________________________ Children’s Birth Certificate(s)________________________________________________________ Marriage Certificate(s)______________________________________________________________ Divorce Decree____________________________________________________________________ Adoption Papers___________________________________________________________________ Deeds and Titles___________________________________________________________________ Mortgages and Notes_______________________________________________________________ Income Tax Records/Returns_________________________________________________________ Veteran Discharge Papers____________________________________________________________ Other Important Papers (Please List)___________________________________________________ _________________________________________________________________________________ _________________________PROFESSIONAL DIRECTORY________________________ Name_______________________________________ Profession___________________________ Address__________________________________________________________________________ City________________________________ State_______________________ Zip_____________ Phone_____________________ Fax________________________ E-mail_____________________ Notes____________________________________________________________________________ Name_______________________________________ Profession___________________________ Address__________________________________________________________________________ City________________________________ State_______________________ Zip_____________ Phone_____________________ Fax________________________ E-mail_____________________ Notes____________________________________________________________________________
  • 17. ______________________________MEDICAL DIRECTORY__________________________ Physician’s Name__________________________________________________________________ Address__________________________________________________________________________ City________________________________ State_______________________ Zip_____________ Phone_____________________ Fax________________________ E-mail_____________________ Notes____________________________________________________________________________ Specialist’s Name__________________________________________________________________ Address__________________________________________________________________________ City________________________________ State_______________________ Zip_____________ Phone_____________________ Fax________________________ E-mail_____________________ Notes____________________________________________________________________________ Chiropractor’s Name________________________________________________________________ Address__________________________________________________________________________ City________________________________ State_______________________ Zip_____________ Phone_____________________ Fax________________________ E-mail_____________________ Notes____________________________________________________________________________ Dentist’s Name____________________________________________________________________ Address__________________________________________________________________________ City________________________________ State_______________________ Zip_____________ Phone_____________________ Fax________________________ E-mail_____________________ Notes____________________________________________________________________________
  • 18. ___________________________________PET DETAILS_______________________________ Name__________________________________________________ Type_____________________ This pet has papers: __Yes ___No The papers are located________________________________ Pet to go to_______________________________________________________________________ Address__________________________________________________________________________ City________________________________ State_______________________ Zip_____________ Phone_____________________ Fax________________________ E-mail_____________________ Veterinarian’s Name_________________________________________ Phone_________________ Allergies_________________________________________________________________________ Feeding Schedule____________________________ Vaccination Schedule____________________ Has the pet been spade, or neutered? ____Yes ____No Name__________________________________________________ Type_____________________ This pet has papers: __Yes ___No The papers are located________________________________ Pet to go to_______________________________________________________________________ Address__________________________________________________________________________ City________________________________ State_______________________ Zip_____________ Phone_____________________ Fax________________________ E-mail_____________________ Veterinarian’s Name_________________________________________ Phone_________________ Allergies_________________________________________________________________________ Feeding Schedule____________________________ Vaccination Schedule____________________ Has the pet been spaded, or neutered? ____Yes ____No Special Instructions_________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________
  • 19. _________________________________MEDICAL HISTORY__________________________ 1). Parents and/or siblings had heart disease, kidney disease, diabetes, cancer, stroke, or any other hereditary disease? ( If yes, indicate family member, illness, age at onset, if applicable, age at death.) ___No ___Yes ________________________________________________________________ 2). Have you had problems with your circulatory, cerebrovascular or cardiovascular systems or blood vessels (such as: heart attack, heart disease, palipitations, heart murmur, chest pain, high blood pressure, stroke, anemia)? ___No ___Yes ________________________________________________________________ 3). Have you had problems your with nose, throat, lung or respiratory system (emphysema, asthma, shortness of breath, chronic cough or sleep apnea)? ___No ___ Yes _________________________________________________________________ 4). Have you had problems with stomach, intestine, rectum, liver or pancreas (such as: hepatitis, ulcer, colitis, Crohn’s disease, or pancreatitis)? ___No ___ Yes _________________________________________________________________ 5). Have you had problems with your nervous system (such as: epilepsy, seizures, multiple sclerosis, depression, suicide, eating disorder, dementia, Alzheimer’s, anxiety, mental illness)? ___ No ___ Yes __________________________________________________________________ 6). Have you had problems with your Endocrine system, bones, muscles, joints, eyes or skin (such as: diabetes, thyroid, lupus, arthritis, or back problems)? ___ No ___ Yes __________________________________________________________________ 7). Have you had Cancer, tumor(s), polyps, melanoma or any other malignancy? ___ No ___ Yes __________________________________________________________________ 8). Have you had problems with your sugar, albumin or blood in urine, or other illness or disease of the kidneys, bladder, or urinary system, prostate, breast, sexually transmitted disease, or any other reproductive disorder? ___ No ___ Yes__________________________________________________________________ 9). Other than listed above are there any other pertinent health problems that your family should be aware of in your health history? ___ No ___ Yes __________________________________________________________________
  • 20. _______________________________________NOTES__________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ ________________________________________________________________________________
  • 21. Thomas Mastromatto NMLS #145824 888-769-7023

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